Posts Tagged physical rehabilitation

Physical and cognitive rehabilitation is usually a challenging activity as people with any kind of deficit has to carry out tasks difficult due to their abilities damaged. Moreover, such difficulties become even harder while they have to work at home in an isolated manner. Therefore, the development of collaborative rehabilitation systems emerges as one of the best alternatives to mitigate such isolation and turn a difficult task into a challenging and stimulating one. As any other collaborative system, the need of being aware of other participants (their actions, locations, status, etc.) is paramount to achieve a proper collaborative experience. This awareness should be provided by using those feedback stimuli more appropriate according to the physical and cognitive abilities of the patients. This has led us to define an awareness interpretation for collaborative cognitive and physical systems. This has been defined by extending an existing proposal that has been already applied to the collaborative games field. Furthermore, in order to put this interpretation into practice, a case study based on an association image-writing rehabilitation pattern is presented illustrating how this cognitive rehabilitation task has been extended with collaborative features and enriched
with awareness information

The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. We propose a general software architecture for our robot coach, which is based on imitation learning techniques using Gaussian Mixture Models. Our system is thus easily programmable by medical experts without specific robotics knowledge, as well as capable of personalised audio feedback to patients indicating useful information to improve on their physical rehabilitation exercise.

Abstract

Purpose of Review

Ramachandran (Nature 377:489–490, 1995) showed that in amputees, phantom limb pain described as a spasming or immobile phantom limb can be alleviated by watching their reflection of the intact limb in a parasagittally placed mirror while moving the intact limb and the phantom simultaneously. This suggested that therapy via mirror visual feedback—mirror therapy—might be considered for other diseases and conditions characterized by poor mobility. We were the first to show that mirror therapy might be beneficial for hemiparesis following stroke. There have now been numerous case reports and studies of mirror therapy for hemiparesis following stroke.

Recent Findings

Overall, the majority of studies done thus far on patients with hemiparesis in the subacute or chronic phase following stroke find mirror therapy to be more beneficial than control treatments. Even when mirror therapy is not superior to control therapy, the reason for this is there are similar improvements in both groups. There have not been adverse effects in patients that perform mirror therapy for hemiparesis following stroke.

Summary

There appears to be a benefit of mirror therapy for hemiparesis following stroke in the subacute and chronic phase. Trial of mirror therapy for hemiparesis may be warranted. Further study of mirror therapy for hemiparesis following stroke will be welcomed; in particular, it would be important to study different groups of patients given the heterogeneity of stroke.

Here is a practical, step-by-step guide to understanding the treatment process and selecting the most appropriate intervention for your patient. Superbly illustrated, in-depth coverage shows you how to identify functional deficits, determine what treatments are appropriate, and then to implement them to achieve the best functional outcome for your patients.

Michael Aratow is a clinician and health care executive who founded VRecover, which is health care startup making physical rehabilitation exercises more engaging with VR. He says that rehab is like homework, but that sometimes up to 90% of people don’t actually do the exercises. VRecover is betting that gamifying rehab exercises within immersive VR environments will help accelerate the healing process while making it more fun to do.

Michael says that governments are looking for ways to cut costs and save money, and he sees that improving the rehab process is a simple and easy way to do that. Not only can surgery be avoided all together in some cases, but it can help accelerate the healing process with both rehabilitation and prehabilitation exercises.

VRecover is planning on developing a number of different VR experiences targeting the most popular rehab exercises starting with issues with the back, arms, and legs. For example, in order to increase the range of motion on the arms, they created a VR experiences where you close blast doors on a space ship. There’s an endless number of possibilities for creating experiences that encourage physical motion and have a therapeutic benefit, and they’ll be using a data-driven approach in deciding which rehab exercises that they’ll be initially targeting.

Michael has been involved with medicine in VR for the past 15 years, and he says that there’s over a decade’s worth of research showing how effect VR treatments are. There’s one study in particular that provided bogus range of motion feedback, and was able to show that people were able to have a wider range of motion that went beyond what they were able to do without VR.

VR rehab has the potential to start to gather more specific data on motion than was possible before. Not only could more accurate range of motion measurements be made over time, but it also could open up new metrics that weren’t possible to measure before such as velocity of movement. This could represent a trend towards personalizing rehab exercises beyond the standardized regiment that has been traditionally been given.

Recover is also going to target physical therapy offices directly rather than the general consumer market. The idea would be that the people would have to come into the office to do rehab exercises within a room-scale VR environment. Their initial prototype was using a Kinect to measure the range of motion, but they haven’t settled on a specific technology stack just yet. Perhaps they’ll eventually sell directly to the consumer market once the adoption of consumer VR grows past the point of existing game consoles, but they’re keeping their customer service demand lower by taking a B2B approach.

Finally, Michael sees that VR provides a new gateway into the mind, and that presence from immersive technologies enable a lot of new healing capabilities through enhancing cognition, controlling pain, and being able to manipulate perception for good.

This paper explores an approach to physical rehabilitation using state-of-the-art technologies in virtual reality and motion tracking; in particular, Oculus Rift DK2 (released in July, 2014) and Intel RealSense (released in November, 2014) are used. A game is developed which requires from the patient to perform an established set of abduction and adduction arm movements to achieve rotator cuff rehabilitation after injury. While conduct of clinical trials is outside the scope of this work, experts in physical rehabilitation working in the medical field have carried out a preliminary evaluation, showing encouraging results.

Abstract
The REHAB@HOME project is intended as an advanced
activity – with the involvement of highly qualified medical
and technical partners, as well as real patients – aimed at an
extensive investigation of the issues related to long-term
physical/cognitive rehabilitation processes and the
identification of suitable technical solutions to efficiently
support them. REHAB@HOME will enable elderly
people to enjoy high quality rehabilitation for a much
longer period than the Health System can currently afford.
By investigating and using standard hardware components
and devices, suitable medical data processing algorithms,
personalized and serious-games based rehabilitation
pathways, Web2.0 social and communication tools, the
project will develop an efficient, effective and engaging
virtual rehabilitation environment for home-based
rehabilitation. The basic project idea is inspired by
existing commercial platforms, like Wii and Kinect, that
allow the user acting within a virtual environment and
interacting with other users, thanks to special input devices
and suitable technologies able to monitor the real
environment and track the user’s behavior. Having this in
mind, REHAB@HOME aim at the user-centred design
and development of an open solution capable to: provide
exercises and training – based on serious-games – within a
personalized, user friendly and engaging rehabilitation
program, offer a cost effective and not bulky infrastructure
with sensors integrated, collect relevant physical and
medical parameters for patients’ status inspection and
relapse prevention, support off-line/on-line management
and monitoring of the rehabilitation protocol, promote
patient’s social participation and community building. In
other words, REHAB@HOME will transform the
patient’s home in a place where physical and cognitive
rehabilitation process can be performed in an intensive and
engaging though properly controlled way, while
promoting social inclusion and quality of life.

In this paper, we present a serious game-based framework for providing live feedback to a patient performing a rehabilitation therapy for the purpose of assisting a patient in correct therapeutic steps and obtaining high quality therapy data for further analysis.

The game environment uses forward kinematics to receive the live sensory data from two 3D motion tracking sensors and uses inverse kinematics to analyze the sensory data stream in real-time. A subject performs a rehabilitation therapy prescribed by the physician and using both forward and inverse kinematics the system validates the angular and rotational positions of the joints with respect to the correct therapeutic posture and provides live feedback to the subject.

As a proof of concept, we have developed an open source web-based framework that can be easily adopted for inhome therapy, without the assistance of a therapist.

Several studies have shown that game-based rehabilitation is a viable option to improve the treatment of patients with physical disabilities. Even though many games are built focusing on rehabilitation, the majority does not present a broad study about the right approach on the many types of existing conditions and also the physiological and medical implications of this games in the patient’s treatments. The actual level of integration between Unity and the body-tracking device supported by Microsoft Kinect, has provided a solid tool to build a serious game focusing the rehabilitation paradigm. This work presents the steps and foundation regarding the subject to build a serious game with focus in rehabilitation of the upper limb, more specifically of those patients with hemiplegia or hemiparesis, with the use of biofeedback analysis to evaluate the patient’s development. It also shows the possibility of the multiplayer perspective into the rehabilitation treatment to help with the learning phase and bring motivation to the gaming experience…